My character is an individual who is working on an MD/PhD at UNC Chapel Hill. She has completed the PhD, Year 5 of her program, in Pharmaceutical Sciences - Medicinal Chemistry and Natural Products. She is heading into MS 4, having completed her clinical clerkships. Now, according to UNCs website, in MS 4, students serve as acting interns and finish other elective courses. In addition, according to UNC's website, during MS4, all MD-PhD students complete a clinical research rotation. This consists of some didactic training with remaining time spent conducting the actual project under the supervision of the clinician scientist (or clinical) mentor. When possible, students join an existing project to gain exposure to the practical aspects of performing clinical research and interacting with human subjects.
The structure of an MD/PhD program is usually 2+4+2, i.e. 2 years of med school, 4 years of grad school (+/- 1 year), then 2 years of med school. When you say year 4 of med school (abbreviated MS4), we would think she is in year 8 of her program overall (abbreviated CD8).
Since this individual actually wants to focus on Natural Product-Derived Chemotherapeutic Agents, I am assuming, for the sake of my story, that she can choose to join an ongoing project of her PhD adviser, in some Phase III clinical trials of a modified natural product on cancer tumors.
That's reasonable. You have to realize that many pharmaceuticals in medicine are derived from natural chemicals, so we usually don't bother to say things like "natural product-derived". Plants have come up with some of the world's best drugs and some of the world's deadliest poisons. At times we modify them, and at times we go completely synthetic, but there's a whole range of drugs out there from a whole range of sources and we study whatever seems to work. Generally in trials like phase 3 trials, the drug is being made by a commercial manufacturer, and if it is in a trial at a medical center like UNC, the physician-investigators doing the clinical trial have nothing to do with the drug's manufacturing.
My questions:
(1) I am assuming once an individual has successfully completed their research dissertation they are a "Dr.", however, in a clinical setting are they really addressed as such by medical/clinical staff if they are in MS 3?
I actually did officially receive a PhD from my MD/PhD program on completion of the PhD portion. However, nobody calls you doctor as a medical student. This is for two reasons,
1) You don't feel like you know much in the hospital (and you don't), and so you're scared someone might actually think you know something.
2) You don't want to confuse patients. Yes, you may technically be a doctor, but in a clinical setting it's not the type of doctor patients are thinking of.
Now to patients sometimes I will introduce myself as Student Doctor and some of the residents/attendings will do that. The term medical student gets me refused by some patients, but student doctor is almost always ok (?). How I'm introduced is team dependent. Since I'm almost 30 I do play a nice doctor impression.I like to just go by my first name and I introduce myself as such.
(2) If this type of individual is working on such clinical trials, I am assuming that she would be actively involved in actually administering the treatments or collecting data from the patients, however, does that mean that she would have direct contact with the patients? For example, assuming a child was involved in the trials, would this individual have direct contact with the child patient and the parents? Would the individual, in administering the treatments or gathering this data, be allowed to have contact with the patient with or without supervision by her clinical mentor or other individual?
Typically a MS4 in a clinical research trial is going to be doing more behind the scenes work analyzing data. The treatments are usually administered by nurses. An MS4 could in theory be seeing the patients in a history and physical exam capacity on the trial to evaluate how patients are doing and look for side effects/disease progression/etc... Their findings would then be backed up by a physician/PA/NP. But, that's not what an MS4 on a clinical trial should be doing in a sense. They should be involved in the planning of research and the analysis and presentation of data, in preparation for a possible career in later clinical research.
